Global, Regional, and National Disability-Adjusted Life Years Burdens of Lower Respiratory Tract Fungal Infections, 1990-2021: A Systematic Analysis of the Global Burden of Disease Study 2021.
Zhiwei Long, Longzhen Lu, Guisheng Xian, Zhengtu Li, Mingkai Guo, Aguo Li, Zhenlin Guan, Feng Ye, Yan Wang
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Abstract
Background: Lower respiratory tract fungal infections (LRTFIs) contribute significantly to global disease burden, yet systematic research is limited. This study analyzes their disability-adjusted life year (DALY) burden, exploring trends, geographic patterns, demographic differences, driving factors, and inequalities.
Methods: Using Global Burden of Disease Study 2021 data, we analyzed global, regional, and national DALYs trends from 1990 to 2021 and forecasted burden to 2050. Decomposition analysis evaluated impacts of population growth, ageing, and epidemiological changes. We analyzed national burden inequalities using the Slope Index of Inequality and the Concentration Index.
Results: Global DALYs from LRTFIs decreased slightly from 1.32 to 1.30 million (1990-2021), with an age-standardized DALY rate (ASDR) decline from 25.86 to 16.37 per 100,000 (EAPC = - 1.52). The highest ASDRs were in low-SDI regions, particularly Central Sub-Saharan Africa (71.86 per 100,000). Zimbabwe, Lesotho, and the Central African Republic had the highest national burdens. Males and individuals over 50 had higher DALY rates. Population growth increased DALYs, while ageing and epidemiological shifts reduced then. Absolute inequality declined, but relative inequality increased. By 2050, DALYs are projected to rise to 1.78 million, though ASDR will decline to 10.37 per 100,000.
Conclusions: Despite progress, LRTFIs burden remains high in underdeveloped regions, particularly Africa. Population growth and ageing will drive future challenges, and significant global inequalities in disease burden persist.
期刊介绍：
Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.
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